Hepatitis A vaccine (Avaxim, Epaxal, Havrix, Vaqta)

What is the hepatitis A vaccine used for?

Preventing hepatitis A in adults and children aged one year and over. Hepatitis A is an inflammation of the liver caused by infection with the hepatitis A virus.

The hepatitis A vaccine is not given routinely. It is recommended for people who are at high risk of contracting hepatitis A, such as:

travellers to high risk areas

laboratory staff who work directly with the virus

people with haemophilia treated with plasma-derived clotting factors

people with severe liver disease

people who are at risk due to their sexual behaviour

workers at risk of exposure to untreated sewage

people who work with primates

staff and residents of homes for those with severe learning difficulties

intravenous drug abusers.

The vaccine may also be considered for close contacts of people with hepatitis A and people with chronic liver disease.

How does the hepatitis A vaccine work?

When the body is exposed to foreign organisms, such as bacteria and viruses, the immune system produces antibodies against them. Antibodies help the body recognise and kill the foreign organisms. The antibodies remain in the body to help protect the body against future infections with the same organism. This is known as active immunity.

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The immune system produces different antibodies for each foreign organism it encounters. This establishes a pool of antibodies that helps protect the body from various different diseases.

The hepatitis A vaccine contains an inactivated form of the virus that causes hepatitis A. It stimulates the immune system to produce antibodies against the hepatitis A virus, but doesn't actually cause the disease. The antibodies produced remain in the body so that if the hepatitis A virus is encountered naturally, the immune system can recognise it and attack it. This prevents it from causing hepatitis A.

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Protection against hepatitis A doesn't occur immediately after having the vaccination, but most people will have protective levels of antibodies after two weeks.

How is the hepatitis A vaccine given?

The hepatitis A vaccine is usually given by injection into the muscle of the upper arm for adults and older children, and the thigh for younger children.

You may be be given the injection under the skin rather than into the muscle if you are at risk of bleeding following an injection into the muscle, for example because you have haemophilia or low levels of platelets in your blood (thrombocytopenia).

A booster dose is usually given 6 to 12 months after the first dose. This provides long-term protection against the disease. A further booster may be needed after 20 years if you are still at risk of contracting the virus.

What should I know before having the hepatitis A vaccine?

This vaccine only provides protection against hepatitis caused by the hepatitis A virus. It will not prevent other forms of hepatitis.

You may not produce enough antibodies in response to this vaccine if you have an underactive immune system (for example due to a genetic defect, disease such as HIV infection, or treatment with immunosuppressant medicines such as chemotherapy, high-dose corticosteroids, or immunosuppressants, eg to prevent rejection of organ transplants). If you fall into one of these categories, your doctor may want you to have a blood test after your injection in order to check the levels of antibodies in your blood. You may need to have additional doses of the vaccine to make sure you produce enough antibodies to protect you from the disease.

Who should not have the hepatitis A vaccine?

People with a sudden feverish illness (the vaccine should be postponed until after recovery).

People who are allergic to formaldehyde, the antibiotic neomycin or any other ingredients used in the manufacturing of the vaccine. The person administering the vaccine can give you this information. Tell them if you have previously had a severe allergic reaction to eggs or chicken protein because one particular brand of the hepatitis A vaccine (Epaxal) should not be given to people with this allergy.

The hepatitis A vaccine is not licensed for babies under one year of age.

Can I have the hepatitis A vaccine while pregnant or breastfeeding?

Certain vaccines should not be given during pregnancy or breastfeeding. However, other vaccines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before having any vaccine.

The safety of the hepatitis A vaccine in pregnancy has not been specifically studied. However, since it contains inactivated virus it is not expected to be harmful. Ask your doctor for advice before having this vaccine if you are, or think you might be pregnant.

The safety of the hepatitis A vaccine during breastfeeding has not been specifically studied. However, based on the effects of other inactivated (ie non-infectious) viral vaccines given during breastfeeding, it's generally considered to be OK for breastfeeding women who are at risk of hepatitis A to have this vaccine. Ask your doctor for further advice.

What are the possible side effects of the hepatitis A vaccine?

Vaccines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with the hepatitis A vaccine. Just because a side effect is stated here does not mean that all people having this vaccine will experience that or any side effect.

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The hepatitis A vaccine does not contain live virus and so cannot cause hepatitis A.

Very common (affect more than 1 in 10 people)

Headache.

Soreness at the injection site.

Feeling weak or tired.

Common (affect between 1 in 10 and 1 in 100 people)

Disturbances of the gut such as diarrhoea, nausea or abdominal pain.

Loss of appetite.

Redness, hardness or swelling of the skin at the injection site.

Aching muscles or joints.

Fever.

Feeling generally unwell.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

Dizziness.

Vomiting.

Rash or itching.

Very rare (affect fewer than 1 in 10,000 people)

Allergic reactions, such asanaphylaxis.

If you think you have experienced a side effect from a vaccine you should get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you. Did you know you can also report side effects yourself using the yellow card website?

Can the hepatitis A vaccine affect other vaccines or medicines?

The hepatitis A vaccine is not known to affect any other medicines.

However, if you're taking certain other medicines the vaccine may be less effective. For example, people taking medicines that suppress the activity of the immune system, such as chemotherapy, high-dose corticosteroids, or immunosuppressants may not produce adequate numbers of antibodies in response to the vaccine. If you are taking any of these medicines you should discuss this with your doctor. You may need an extra dose of the vaccine.

The hepatitis A vaccine may be given at the same time as other vaccines, but if so, the other vaccines should be administered into separate sites and preferably into separate limbs.

What types of hepatitis A vaccine are available?

Hepatitis A vaccine is available as a single vaccine with the following brand names:

Avaxim.

Epaxal.

Havrix.

Vaqta.

It's also possible to be vaccinated against hepatitis A with the following combined vaccines:

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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